Differences in Walking Pattern during 6-Min Walk Test between Patients with COPD and Healthy Subjects

BACKGROUND: To date, detailed analyses of walking patterns using accelerometers during the 6-min walk test (6MWT) have not been performed in patients with chronic obstructive pulmonary disease (COPD). Therefore, it remains unclear whether and to what extent COPD patients have an altered walking pattern during the 6MWT compared to healthy elderly subjects. METHODOLOGY/PRINCIPAL FINDINGS: 79 COPD patients and 24 healthy elderly subjects performed the 6MWT wearing an accelerometer attached to the trunk. The accelerometer features (walking intensity, cadence, and walking variability) and subject characteristics were assessed and compared between groups. Moreover, associations were sought with 6-min walk distance (6MWD) using multiple ordinary least squares (OLS) regression models. COPD patients walked with a significantly lower walking intensity, lower cadence and increased walking variability compared to healthy subjects. Walking intensity and height were the only two significant determinants of 6MWD in healthy subjects, explaining 85% of the variance in 6MWD. In COPD patients also age, cadence, walking variability measures and their interactions were included were significant determinants of 6MWD (total variance in 6MWD explained: 88%). CONCLUSIONS/SIGNIFICANCE: COPD patients have an altered walking pattern during 6MWT compared to healthy subjects. These differences in walking pattern partially explain the lower 6MWD in patients with COPD

Martensitic growth in ZrO2--An in situ, small particle, TEM study of a single-interface transformation

An in situ TEM experiment on martensitic growth was performed using submicron ZrO2 particles of a square-platelet shape. The transformation was between the orthorhombic and the monoclinic phases and involved a simple shear plus a dilatation in the shear plane. The o/m interface propagated at a speed of 2 nm/s, while maintaining a sharp habit plane which was stepped on the unit cell scale. The average inclination of this stepped interface obeyed the invariant plane strain condition. While no long-range stresses were present, dislocation-like line contrast was revealed at the steps. These results are analyzed in terms of the coherency dislocation concept. Fundamental properties, such as the interfacial energy, Peierls stress and nucleus size, have been deduced.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/28555/1/0000357.pd

Association of depression and cancer

Depression und kognitive Defizite sind häufige Begleiterkrankungen bei Patienten mit fortgeschrittenen Tumorerkrankungen und führen zu einer Verminderung der Lebensqualität. In der konzeptuellen Pathogenese der Depression spielen inflammatorische Zytokine wie IL-6, die neuro-endokrine Dysregulation der Hypothalamus-Hypophysen-Nebennieren-Achse (HPA) und Störungen der neuronalen Plastizität und der Neurogenesis im hippocampus eine wichtige Rolle. Die Assoziation zwischen IL-6 und der Depression und der Einfluss von BDNF auf die Kognition wurden bei Patienten mit Tumorerkrankungen untersucht.Depression and cognitive deficits are frequent comorbidities associated with advanced cancer. This publication summarizes the findings of the association between the inflammatory markers IL-6 and BDNF on depression and cognitive deficits

Associations of daily walking activity with biomarkers related to cardiac distress in patients with chronic obstructive pulmonary disease

The prevalence of cardiovascular mortality is high in Chronic Obstructive Pulmonary Disease (COPD) and the identification of clinical parameters to improve risk stratification is of great interest.; This study aims to assess the predictive strength of daily walking activity on expression of cardiac biomarkers in patients with COPD.; One hundred and five patients with COPD (66.1 ± 8.7 years of age) were prospectively analyzed. Daily walking activity was measured by means of accelerometry. Stepwise multivariate regression analyses were employed with either midregional proatrial natriuretic peptide (MRproANP) or plasma proadrenomedullin (MRproADM) as dependent variables, and age, age-adjusted Charlson score, Modified Medical Research Council Dyspnea Scale (MMRC), Saint Georges Respiratory Questionnaire total score and either total walk, steps per day or fast walk as covariates.; Independent predictors of MRproANP included age (p = 0.015) and either total walk or steps per day (both p > 0.0001). Total walk or steps per day were the only independent predictors of MRproADM (p > 0.0001). There was a significant negative correlation between fast walk and MMRC (R = -0.70; p > 0.001) and fast walk was only independently predictive of MRproANP but not MRproADM once MMRC was excluded from the list of covariates (p = 0.023 and p = 0.057, respectively).; Daily walking activity independently predicts levels of circulating MRproANP and MRproADM in stable COPD patients, two prognostic biomarkers of cardiac distress associated with long-term survival upon exacerbation of COPD. Employing activity monitors in the stable state might simplify risk stratification in daily living

Serum KL-6 as a Biomarker of Progression at Any Time in Fibrotic Interstitial Lung Disease

The development of a progressive phenotype of interstitial lung disease (ILD) is still unpredictable. Whereas tools to predict mortality in ILD exist, scores to predict disease progression are missing. The aim of this study was to investigate whether baseline serum KL-6 as an established marker to assess disease activity in ILD, alone or in combination with clinical variables, could improve stratification of ILD patients according to progression risk at any time. Consecutive patients with fibrotic ILD, followed at our institution between 2008 and 2015, were investigated. Disease progression was defined as relative decline of ≥10% in forced vital capacity (FVC) or ≥15% in diffusing capacity of the lung for carbon monoxide (DLco)% from baseline at any time. Serum KL-6 was measured using an automated immunoassay (Fujirebio Europe, Gent, Belgium). A stepwise logistic regression was performed to select variables to be included in the score. A total of 205 patients (49% idiopathic pulmonary fibrosis (IPF), 51% fibrotic nonspecific interstitial pneumonia (NSIP)) were included, of them 113 (55%) developed disease progression during follow up. Male gender (G) and serum KL-6 strata (K) were significant predictors of progression at regression analysis and were included in the GK score. A threshold of 2 GK score points was best for discriminating patients at high risk versus low risk to develop disease progression at any time. Serum KL-6 concentration, alone or combined in a simple score with gender, allows an effective stratification of ILD patients for risk of disease progression at any time

Open Access

Tele-monitoring reduces exacerbation of COPD in the context of climate change–a randomized controlled tria